| NPI | 1548255276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TN MD47590) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TN MD47590) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IA 28210) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IA 28210) | |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2022-03-25 |